Description

Maritime pine trees grow in countries on the Mediterranean Sea. The bark is used to make medicine. Maritime pine trees that grow in an area in southwest France are used to make Pycnogenol, the US registered trademark name for a commercially available maritime pine bark extract.

Maritime pine bark extract is used for asthma, improving athletic performance, poor circulation that can cause the legs to swell (chronic venous insufficiency or CVI), and many other conditions, but there is only limited scientific evidence to support some of these uses.

Effectiveness Header

Natural Medicines rates effectiveness based on scientific evidence according to the following scale: Effective, Likely Effective, Possibly Effective, Possibly Ineffective, Likely Ineffective, Ineffective, and Insufficient Evidence to Rate.

Possibly Effective

• Asthma. Taking a standardized extract of maritime pine bark daily, along with asthma medications, seems to decrease asthma symptoms and the need for rescue inhalers in children and adults with asthma. Keep in mind that maritime pine bark extract shouldn’t be used in place of asthma medicine.
• Athletic performance. Young people (age 20-35 years) seem to be able to exercise on a treadmill for a longer time after taking a standardized extract of maritime pine bark daily for about a month. Also, athletes training for a physical fitness test or a triathlon seem to perform better in the tests and competitions when they take this extract daily for 8 weeks while training.
• Poor circulation that can cause the legs to swell (chronic venous insufficiency or CVI). Taking a standardized extract of maritime pine bark by mouth seems to reduce leg pain and heaviness, as well as fluid retention, in people with circulation problems. Using this extract with compression stockings also appears to be more effective than using compression stockings alone. Some people also use horse chestnut seed extract to treat this condition, but using the maritime pine bark extract appears to be more effective.

Possibly Ineffective

• High cholesterol. Most evidence shows that a standardized extract of maritime pine bark does not lower “bad cholesterol” (low-density lipoprotein (LDL) cholesterol) in people with high cholesterol.

Insufficient Evidence

Decline in memory and thinking skills that occurs normally with age. Most research in healthy elderly people did not find memory or thinking skills benefit after taking a standardized extract of maritime pine bark.

• Hardening of the arteries (atherosclerosis). There is some evidence that taking a standardized extract of maritime pine bark three times daily for 4 weeks might help improve some complications caused by hardening of the arteries.
• Attention deficit-hyperactivity disorder (ADHD). Taking a standardized extract of maritime pine bark by mouth does not seem to help ADHD symptoms in adults. However, taking it by mouth for one month appears to improve symptoms in children.
• A rare disease involving severe ulcers in the mouth and other parts of the body (Behcet syndrome). Early research shows that taking a standardized extract of maritime pine bark improves symptoms in people with Behcet syndrome.
• Enlarged prostate (benign prostatic hyperplasia or BPH). Early research found that taking a standardized extract of maritime pine bark is linked to better ability to urinate in people with BPH.
• Memory and thinking skills (cognitive function). Early research found that taking a standardized extract of maritime pine bark by mouth improves mental function and memory in adults. It also seems to slightly improve test scores in college students.
• Decline in memory and thinking skills in older people that is more than what is normal for their age. Early research shows that taking a standardized extract of maritime pine bark improves mental function in adults with mild mental impairment.
• Common cold. Early research found that taking a standardized extract of maritime pine bark by mouth twice daily starting at the beginning of a cold seems to reduce the number of days with a cold and. It also may reduce the amount of over-the-counter cold products needed to manage symptoms.
• Tooth plaque. Early research suggests that chewing at least 6 pieces of gum with added extract from maritime pine bark for 14 days reduces bleeding and prevents increased plaque.
• Diabetes. Early evidence suggests that taking a standardized extract of maritime pine bark daily for 3-12 weeks slightly decreases blood sugar in people with diabetes.
• Foot sores in people with diabetes. Early research suggests that taking maritime pine bark extract by mouth and applying it to the skin helps heal foot ulcers related to diabetes.
• A disease of small blood vessels in people with diabetes (diabetic microangiopathy). Early research shows that taking standardized maritime pine bark extract three times daily for 4 weeks improves circulation and symptoms in people with diabetes.
• Vision problems in people with diabetes (diabetic retinopathy). Taking a standardized extract of maritime pine bark by mouth for 2 months seems to slow or prevent further worsening of retinal disease caused by diabetes, atherosclerosis, or other diseases. It also seems to improve eyesight.
• Dry mouth. Early research shows that taking a standardized extract of maritime pine bark along with artificial saliva improves mouth dryness better than artificial saliva alone.
• Erectile dysfunction (ED). Early research suggests that standardized maritime pine bark extract, used alone or in combination with L-arginine, might improve sexual function in men with ED. It seems to take up to 3 months of treatment for significant improvement.
• Hay fever. Some research shows that taking a standardized extract of maritime pine bark before the start of allergy season reduces allergy symptoms in people with birch allergies.
• Hemorrhoids. Early research shows that taking a standardized extract of maritime pine bark by mouth, alone or in combination with a cream containing this same extract, improves quality of life and symptoms of hemorrhoids. Other research shows that taking this same extract by mouth can improve the symptoms of hemorrhoids in women after giving birth.
• High blood pressure. Some research shows that taking a standardized extract of maritime pine bark can lower blood pressure. But other research has shown no effect.
• A long-term disorder of the large intestines that causes stomach pain (irritable bowel syndrome or IBS). Early research found that taking a standardized extract of maritime pine bark can reduce abdominal pain, cramps, and medication use in people with IBS.
• Jet lag. Early research found that taking a standardized extract of maritime pine bark, starting 2-3 days before a plane flight, can shorten the time that jet lag symptoms occur and also reduce the symptoms of jet lag.
• Leg cramps. There is some evidence that taking a standardized extract of maritime pine bark by mouth daily might decrease leg cramps.
• An inner ear disorder marked by dizziness, hearing loss, and ringing in the ear (Meniere disease). Early research shows that taking a standardized extract of maritime pine bark can decrease ringing in the ears and overall symptoms in adults with Meniere’s disease.
• Symptoms of menopause. Early research found that taking a standardized extract of maritime pine bark by mouth decreases menopausal symptoms, including tiredness, headache, depression and anxiety, and hot flashes.
• A grouping of symptoms that increase the risk of diabetes, heart disease, and stroke (metabolic syndrome). Early research suggests that taking a standardized extract of maritime pine bark by mouth three times daily for 6 months lowers triglycerides, blood sugar levels, and blood pressure, and increases high-density lipoprotein (“good” or HDL) cholesterol in people with metabolic syndrome.
• Swelling (inflammation) and sores inside the mouth (oral mucositis). Applying a solution containing a standardized extract of maritime pine bark inside the mouth for one week seems to help heal mouth ulcers in children and adolescents undergoing chemotherapy treatment.
• Osteoarthritis. There is mixed evidence about the effectiveness of maritime pine for osteoarthritis. Taking a standardized extract of maritime pine bark by mouth might reduce overall symptoms, but it does not seem to reduce pain or improve the ability to perform daily tasks. Early research also found that applying patches with standardized extract of maritime pine bark to the skin might reduce pain in people with osteoarthritis of the knee.
• Parkinson disease. Early research found that taking a standardized extract of maritime pine bark along with levodopa/carbidopa therapy improves tremor and other physical symptoms. It also seems to improve mental function.
• Pain in women who are pregnant. Early research suggests that taking a standardized extract of maritime pine by mouth daily during the last 3 months of pregnancy reduces lower back pain, hip joint pain, pelvic pain, and pain due to varicose veins or calf cramps.
• Pelvic pain in women. There is early evidence that taking a standardized extract of maritime pine bark by mouth might help reduce pelvic pain in women with endometriosis or severe menstrual cramps.
• Scaly, itchy skin (psoriasis). Early research found that taking a standardized extract of maritime pine bark by mouth can reduce the size of skin plaques, improve quality of life, and reduce the use of steroids in people with psoriasis.
• Painful response to cold especially in the fingers and toes (Raynaud syndrome). Early research found that taking a standardized extract of maritime pine bark can improve coldness and pain in the fingers in people with this condition.
• Age-related muscle loss (sarcopenia). Early research found that taking a standardized extract of maritime pine bark by mouth improves muscle function in elderly adults with signs of muscle loss.
• An autoimmune disorder in which the glands that produce tears and saliva are damaged (Sjogren syndrome). Early research in people with Sjogren syndrome found that taking a standardized extract of maritime pine bark by mouth reduces symptoms of dry eye and dry mouth. It also might reduce the need for certain medicines.
• An autoimmune disease that causes widespread swelling (systemic lupus erythematosus or SLE). Early research suggests that taking a standardized extract of maritime pine bark by mouth reduces symptoms of SLE in some patients.
• Ringing in the ears (tinnitus). Early research suggests that taking a standardized extract of maritime pine bark reduces ringing in the ears.
• Varicose veins. Early research shows that taking a standardized extract of maritime pine bark can reduce leg cramps, leg swelling, and the number of varicose veins and spider veins in women after giving birth.
• Blood clots that form in the veins (venous thromboembolism or VTE). Taking a specific maritime pine bark extract alone before and after a long flight doesn’t seem to prevent blood clots in people at high risk. But it might reduce the risk of post-thrombotic syndrome. This condition can develop in people who already had a blood clot.
• Heart failure.
• Muscle soreness.
• Problems with sexual function.
• Stroke prevention.
• Other conditions.

More evidence is needed to rate maritime pine for these uses.

Action

Maritime pine contains substances that might improve blood flow. It might also stimulate the immune system, reduce swelling, prevent infections, and have antioxidant effects.

Safety

When taken by mouth: A standardized extract of maritime pine bark (Pycnogenol, Horphag Research) is POSSIBLY SAFE in doses of 50-450 mg daily for up to one year. It may cause dizziness, stomach problems, headache, mouth sores, and bad breath.

When applied to the skin: A standardized extract of maritime pine bark (Pycnogenol, Horphag Research) is POSSIBLY SAFE as a cream for up to 7 days or as a powder for up to 6 weeks.

Special Precautions & Warnings:

Pregnancy and breast-feeding: Early research suggests that a standardized extract of maritime pine bark (Pycnogenol, Horphag Research) is POSSIBLY SAFE when used in late pregnancy. However, until more is known, it should be used cautiously or avoided by women who are pregnant.

There is not enough reliable information about the safety of taking maritime pine products if you are breast-feeding. Stay on the safe side and avoid use.

Children: A standardized extract of maritime pine bark (Pycnogenol, Horphag Research) is POSSIBLY SAFE when taken by mouth, short-term.

“Auto-immune diseases” such as multiple sclerosis (MS), lupus (systemic lupus erythematosus, SLE), rheumatoid arthritis (RA), or other conditions: Maritime pine might cause the immune system to become more active, and this could increase the symptoms of auto-immune diseases. If you have one of these conditions, it’s best to avoid using maritime pine..

Bleeding conditions: In theory, high doses of maritime pine might increase the risk of bleeding in people with bleeding conditions.

Diabetes: In theory, high doses of maritime pine might decrease blood sugar too much in people with diabetes.

Hepatitis: In theory, taking maritime pine might worsen liver function in people with hepatitis.

Surgery: Maritime pine might slow blood clotting and reduce blood sugar. There is some concern that it might cause blood sugar to go too low and increase the chance of bleeding during and after surgery. Stop using maritime pine at least 2 weeks before a scheduled surgery.

Drug Interactions

Medications that decrease the immune system (Immunosuppressants)

Interaction Rating=Moderate Be cautious with this combination.

Pycnogenol seems to increase the immune system. By increasing the immune system pycnogenol might decrease the effectiveness of medications that decrease the immune system.

Some medications that decrease the immune system include azathioprine (Imuran), basiliximab (Simulect), cyclosporine (Neoral, Sandimmune), daclizumab (Zenapax), muromonab-CD3 (OKT3, Orthoclone OKT3), mycophenolate (CellCept), tacrolimus (FK506, Prograf), sirolimus (Rapamune), prednisone (Deltasone, Orasone), corticosteroids (glucocorticoids), and others.

Herb Interactions

Herbs and supplements that might lower blood sugar: Maritime pine might lower blood glucose levels. Using it with other herbs or supplements that have the same effect might cause blood sugar levels to drop too low. Some herbs and supplements that can lower blood sugar include alpha-lipoic acid, chromium, devil’s claw, fenugreek, garlic, guar gum, horse chestnut, Panax ginseng, psyllium, Siberian ginseng, and others.
Herbs and supplements that might slow blood clotting: Using maritime pine along with herbs that can slow blood clotting could increase the risk of bleeding in some people. These herbs include angelica, clove, danshen, garlic, ginger, ginkgo, Panax ginseng, and others.

Food Interactions

There are no known interactions with foods.

Dosage

The following doses have been studied in scientific research:

ADULTS

BY MOUTH:

• Asthma: 1 mg of a standardized maritime pine bark extract per pound of body weight, up to a maximum of 200 mg/day, has been given in two divided doses for one month. Also, 50 mg of the same extract has been used twice daily for 6 months.
• Athletic performance: 100-200 mg a standardized maritime pine bark extract has been used daily for 1-2 months.
• Poor circulation that can cause the legs to swell (chronic venous insufficiency or CVI): 45-360 mg of a standardized maritime pine bark extract has been taken daily in up to three divided doses for 3-12 weeks.

CHILDREN

BY MOUTH:

• Asthma: 1 mg of a standardized maritime pine bark extract per pound of body weight has been taken in two divided doses for 3 months by children and adolescents aged 6-18 years.

Other Names

Condensed Tannins, Écorce de Pin, Écorce de Pin Maritime, Extrait d’Écorce de Pin, French Marine Pine Bark Extract, French Maritime Pine Bark Extract, Leucoanthocyanidins, Maritime Bark Extract, Oligomères de Procyanidine, Oligomères Procyanidoliques, Oligomeric Proanthocyanidins, OPC, OPCs, PCO, PCOs, Pine Bark, Pine Bark Extract, Pinus pinaster, Pinus maritima, Proanthocyanidines Oligomériques, Procyanidin Oligomers, Procyanodolic Oligomers, Pycnogenol, Pycnogénol, Pygenol, Tannins Condensés.

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